KIDS’ DENTAL EXCHANGE PLANS ARE RELEASED

Families who buy health coverage on the state’s new exchange will also be able to buy dental insurance for their children, Covered California officials said Tuesday.

Peter Lee, Covered California’s executive director, released pediatric dental rates ranging from $10 to $40 per month that he said will allow as many as 140,000 currently uninsured California children to get dental coverage.

“We believe that pediatric dental coverage for kids is an important part of good health,” Lee said at a news conference in Sacramento.

The dental announcement is just one piece of the larger health reform law, which requires nearly all Americans to be covered by some sort of health insurance starting on Jan. 1, 2014.

If families and individuals don’t already get coverage from their employer or from a government program like Medicare or Medi-Cal, they will be able to buy coverage from the state’s exchange.

Lee announced basic rates for the new exchange in late May, drawing praise from many quarters for premiums that weren’t as high as many predicted.

The pediatric dental plans announced Tuesday will be available as add-on coverage to those who buy a main health policy through Covered California, said an exchange spokeswoman.

Unlike basic health coverage, the federal law does not mandate dental coverage for all Americans, Lee said.

It does require each state’s health exchange to make pediatric dental coverage available. There is no mandate for adult dental coverage, though Lee said the exchange may begin offering plans in April 2014.

He added that the federal law also allows states to mandate pediatric dental coverage, but California has not decided to take that route at this time.

“We’re still analyzing the federal guidelines to the extent that states can make that a requirement,” Lee said.

Dr. Paul Reggiardo, spokesman for the American Association of Pediatric Dentistry, said that he and many other dentists applaud the plans announced Tuesday, but added that many had hoped that California would make them mandatory.

“It’s going to be progress for sure, but it falls short of the gold standard of 100 percent coverage for kids,” Reggiardo said.

Dr. Robert Hanlon, an Escondido endodontist and past president of the San Diego County Dental Association, said dental health is an important topic for children.

“Dental disease is the No. 1 reason why children miss school. Dental disease is also the No. 1 most preventable disease in the country, so we applaud anything that increases access,” Hanlon said.

While doctors were generally supportive, the health insurance industry seemed less excited.

Neil Crosby, vice president of public affairs for the California Association of Health Underwriters, noted that the pricing announced Tuesday was for a single child only. He said that pediatric dental plans now generally cost between $10 and $30 per month, depending on how much of a patient’s bill is covered and how much must be spent out of pocket.

“The rates may be comparable if you have one dependent, but if you have multiple children, then you are going to end up paying more,” Crosby said.

How much more remains a question.

Anne Gonzales, an information officer for Covered California, said the exchange did solicit rates covering families with two or more children. But she could not specify when those rates would be released. She added that multi-child rates will not necessarily be multiples of the single-child rate.

“Those rates are not calculated on a per-child basis,” she said.

What is known is that, at least for a single child, there will be six different insurance companies offering dental plans on the exchange.

Those plans are required to offer “high” and “low” levels of service. The high level of service pays 85 percent of a patient’s bill, while the low benefit plans pay 70 percent.

None of the plans have waiting periods for coverage, Lee said, meaning that coverage starts on the first of the month after a policy is purchased. Unlike many currently available plans, Lee noted, the exchange dental plans have no cap on out-of-pocket expenditures in a calendar year.